Tonsillectomy Journal

Purpose

I am having a tonsillectomy Tuesday morning, May 15. I wasn't able to find much good data on what to expect on the internet, so I am going to try to relay my thoughts and experience to you through this online journal. Hopefully through this, others who need to go through the operation will be able to have a better idea of what to expect. I'll also hopefully remember to update you with more information in about a year from now, so that you can tell if the surgery actually helped me or not.

Sunday, May 13 (T-2 Days)

T-36 Hours or so. The trepidation is beginning to set in, but rationally I know that I can handle a week to two weeks of serious pain if it means that I won't have to deal with getting strep constantly. For instance, in the past year (my freshman year at college) I've probably been sick every month to month and a half - call it 6-8 instances in the past 8 months. I went to my pre-op checkup on Friday and everything seems to look good. I am currently taking liquid Amoxicillin because I have a minor cold at the moment. Additionally, it should help to keep the site clean after surgery. In terms of painkiller, I've been given Hydrocodone Bitartrate and Acetaminophen Oral solution, with instructions to take 10-15mL every 4-6 hours as needed. The doctor says that this should help to keep the edge of the pain, but won't make it go away completely.


I've stocked up on entertainment to keep me occupied for the next ten days. I'm going to be playing a lot of God of War and Bloodborne, and then also watching Mad Men and Westworld. Tomorrow I will update you with what I've bought in preparation, as well as how I am coping with the anxiety of going into surgery.

Attached are images of my tonsils as of last week.

Pre-Op Tonsil Appearance

Monday, May 14 (T-1 Days)

Ok, so I'm doing this thing tomorrow. I'm still a bit nervous as I have a slight cold at the moment, but I'll make sure that I tell the doctors that before I go into surgery tomorrow. I'm sure that they know what they are doing. I was actually starting to get nervous, so I decided to look up the history of the surgery on Wikipedia - turns out that people have been doing this operation for at least 2,500 years so I know that it's not like they are doing some sort of experimental, far out thing on me. 

Actually, strangely enough I haven't really had a serious case of nerves yet. I figure that it's a mix between being resigned to the fact that I need to have it, as well as the fact that even people who had their surgeries go horribly wrong (bleeding, infections, etc.) still don't seem to regret their decision. And I guess a part of me is also looking forwards to the losing weight aspect. I'm roughly 210-213lbs, 6'5" at the moment, but I honestly usually feel happier around 200-203 lbs. Plus, I usually heal fairly quickly so hopefully that's the case for this ordeal as well.

Today, my Mom and I went to Stop & Shop to go and buy some supplies. I'm all stocked up on apple sauce, jello, popsicles, and Danimals (holy moly those were a lifesaver when I got my wisdom teeth removed.) Frankly, on the food front I feel fairly well prepared. We didn't get a humidifier, but hopefully that's not an issue. I'm planning on sleeping in four hour chunks - maybe four hours in the night and four in the afternoon - that way my pain won't be able to catch up on me. I've had to sleep in such a piecemeal fashion before, so it shouldn't be too much of an issue. According to what I've read online, pain is highly variable so hopefully I will find myself on the low end of that spectrum.

Anyways, off to go play some more videogames and hopefully get a good night's rest before tomorrow. I need to get to the hospital by 7:30am, and then I should be all set to go by 11:00am. Not too bad in all honesty. 

Here's to hoping that I'm not too loopy tomorrow - hopefully I'll find it in me to post a semi-lucid update.

Tuesday, May 15 (Day of Operation)

Ok, so today was the big day. I woke up at like 6:45am and then went to have a shower. I distinctly remember that I could feel a minor sore on the back of my right cheek, but in retrospect that was probably just me psyching myself out. I also felt really dehydrated, which was strange because I had made sure to drink a ton of water right before midnight. Anyways, I got up and then promptly headed to the shower. I figured that depending on how much pain I was in today, it might be the last shower that I could take in quite some time (don't want to slip and fall in the shower, you see.) 

So at around 7:00am we get in the car and drive to the OR. Thirty minutes later, we arrive. Get there, get checked in, sign some forms, etc., etc. The nurses were super nice. I had had a vitamin C/multivitamin drink the night before, so when I was told that I should have avoided vitamin E I had a minor freakout. Fortunately, my multivitamins didn't have vitamin E in them so I was all good to go.

Around 8:00am the nurse came around and put my IV in. She told me I might feel faint when they put it in, so I looked away just in case (I don't like the sight of my own blood in medical settings.) A quick pinch later, and I was all set. From then on out, all I could feel was a slight pressure around the area. The main thing about the IV was that it quickly rehydrated me, so I didn't feel so thirsty. That was awesome. 

The Anesthesiologist and ENT came around to come and check up on me. They told me that I was getting both my tonsils and adenoids out today, which was slightly worrying. Luckily, the ENT told me that this would have no effect on the length/level of pain experienced during my recovery. Other than that, I didn't do much except for talk to my dad for the next hour or so. 

At around 8:45am - 9:00am I was taken into the OR. It's FREEZING in there!!! They had a bunch of people and somewhat scary looking machines, but honestly, it wasn't so much of an issue. The main problem was that the operating table was a bit too short for me, so my legs dangled off of the edge of the table. They put an oxygen mask over my head, the doctors asked me a few quick questions about my medical history, and then lights out.

As expected, I woke up at around 10:15am-10:30am. I felt super groggy, and it kinda felt as though I had overly strained my eyes to some extent. I tried to speak, but quite frankly my motor coordination wasn't quite there (gotta reboot the system, so to speak.) I tried to write down some notes for the nurses, and eventually, I was able to "write" down some half-legible chicken scratch. 

From then on out I was on the up and up. Lucidity slowly crept back, and then my hands started to work properly again. My legs were definitely the last body part to come back online - I'm assuming that that is because they have such big muscles that likely absorb a ton of the general anesthetic. 

The nurses gave me a bunch of popsicles, which I promptly wolfed down. I think I had about 7 or 8 of them. I would highly recommend them - the cold helps to numb the throat area and they are good for hydration. I also tried to drink a bunch of water - I had read online that keeping hydrated would aid in the healing process. Lastly, ice chips are a lifesaver. Get those!!!

Anyways, the doctors elected to keep me there for three hours post op, so I ended up exiting at around 1:00pm. I didn't feel as though I really needed it, but I took some oxycodone at around 12:45pm. Again, I did this because I had read that it is best to stay ahead of the pain.

It's around 3pm right now, and I still don't feel any pain. I just feel slightly stuffy around the throat area, which is likely due to inflammation. I had a bit of pain waking up, but the ice and oxy sorted that out completely. Oh, and one more thing. My airways feel the most open that they have ever felt. It's kinda like the feeling of pure relief that washes over you when your chest is feeling tight and then you take albuterol or are given medical oxygen. Even if this was the only benefit, it would have been well worth it to have the surgery. Stay tuned for day 2!


P.S. Writing at 12:08am on Wednesday. Pain is still very low to nonexistent, but the swelling might have gotten a bit worse. Danimals are a lifesaver - definitely get them. My comfort in speaking has gone down over the past few hours, so I've been resorting to the use of my phone to text my parents and other family members with requests/jokes. Also, my doctor used the electro-cauterization technique for anyone who was wondering. Lastly, I took 7.5mL of the narcotic solution about 20 mins ago. The dosage is for 10-15mL, but I really like being lucid and I figure that if I wake up from pain I just need to soldier through to 4:00am before I can take another dose.

Wednesday, May 16 (Day 1)

It's 9:08am. I just woke up, or at least I just, just woke up. I probably actually came to at around 8:00am. Not gonna lie, the pain is definitely worse than it was yesterday. My first thought was, Holy shit this is sore. I spent a good while fumbling around with my nasal spray, trying to clear my nose in an attempt to ease my breathing. My face feels hot. I didn't sleep especially well (but then again, it also wasn't horrible.)

Luckily, my parents are awesome. I texted them and my mom was kind enough to bring up some popsicles and ice water from the fridge downstairs. I also took my morning dose of liquid Amoxicillin - that stuff tastes like childhood. And ice water was definitely the move. It simultaneously numbs the throat and reduces the swelling - I highly, highly, recommend it as an alternative to narcotics. 

The one thing you do want to be careful about is popsicles - I've found that the red found in red popsicles, combined with the viscous nature of sugary things, leads to a blood like appearance. This can make it more difficult to tell whether you are bleeding or just enjoying a sugary treat. Oh, and as with anything with a high sugar content, eating too much of it can put you at risk for developing phlegm. You don't want this - coughing is scary and phlegm makes your chest sound wheezy as all hell. Definitely be conscientious about what you eat at this stage. And if you are a few days away from surgery, try to limit your food intake. I've found that I haven't had to deal with too much in the way of hunger pangs through a combination of constant hydration and by having restricted my diet for about three days before the operation. Off to play some more Bloodborne.

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Ok, so a bunch has happened in the past 10 hours or so. It's now 7pm. I ended up taking 10mL of painkiller at around 11:45am. This turned out to be a good idea, as I promptly coughed up two massive chunks of brown looking mucous. Such an action would likely have been excruciatingly painful had I not been slightly drugged up.

Additionally, there is a certain technique that one can use in order to clear the throat without feeling like absolute death. Most of my phlegm has been generated fairly far back in my throat, so I have found that if I make small little coughs I can work most of my phlegm up to the top of my throat. This is where it gets tricky - you see, it's painful to use the back of my mouth muscles to spit out the phlegm seeing as half of that region is completely cauterized. Instead of using those muscles, you should just kneel over the toilet and gradually spit. Eventually, gravity will work its magic and a phlegm chunk will ooze out of your mouth. Don't worry if the mucous looks absolutely disgusting - so long as there isn't any red when you spit you should be all good to go. If worried, gently sloosh some water around in your mouth and then spit it out. If the water has red in it, make sure to call your ENT.

Phlegm on Day 2

After my little phlegm bonanza, my Mom left to go get lunch with some of her friends. I went downstairs and played some video games, but then realized that my reaction times under the influence of hydrocodone-acetaminophen are too slow to actually defeat bosses in a game as difficult as Bloodborne. Should've downloaded something that isn't quite at Dark Souls levels of difficulty.


Instead, I decided to watch Mad Men. My God, that show is incredible. Make sure that you have a good show to watch - it really helps to make the ordeal go by more quickly. I think sometime around 3 or 4pm I dosed off, only to wake back up at 6pm with a fairly sore mouth. I'm still effectively mute at this point, which really sucks. Actually let me clarify - my throat was damn sore when I woke up, and I was lucky to have a bunch of ice chips and popsicles nearby to numb my pain. This concept is key - make sure that you have something cold nearby to eat or drink or else you will have to take more pain medication than you probably should. Additionally, the presence of a humidifier is key - I slept with my mouth open and my throat would have been dry if not for the newly installed CVS humidifier in my man cave. 
At 6:45pm today I took my liquid amoxicillin and 10mL of the painkiller. I'm trying to restrict myself to 10mL per every 6 hours - that's the lowest recommended dose and I would rather deal with pain than deal with addiction, no matter how unlikely such a scenario is. Additionally, days 3-6 (Thursday through Monday) are meant to be absolute hell so I'd rather minimize the amount of time for which I am continuously drugged up.I'm going to try and have some ice cream right now - I've eaten only 560 calories today through a mix of Danimals and popsicles which is probably less than ideal. For comparison's sake, I probably consume around 2,500-3000kcal on most days. It's 9:45pm. Omg the pain is so much worse. My ice bucket is my only friend. 

My only friend.

Thursday, May 17 (Day 2)

Not to wax poetic or anything, but getting a tonsillectomy is damn sore. Frankly, I'm tempted to use more explicit language, but there is no doubt in my mind that using such language would be a good way to really irritate my parental units. I took 15 mL of medication, the absolute max dose, at around midnight. As usual, it took around twenty minutes to hit me and then suddenly I could actually operate like a normal human being. I quickly chugged down some 1000-1250mL of ice water - I don't think I'll ever be this hydrated again. I then read about plasma donation schemes in The Economist for about thirty minutes before reminding myself that my relief would not last and that I ought to try and sleep before the sea of pain reared its ugly head once more. 

I made sure to position my body at a near 90 degree angle so as to prevent phlegm from blocking my airways as I slept. I then dozed off, getting to sleep by 1:30am. Unfortunately, good things don't last and I woke up at around 3:30am from the symptoms of full bladder and tonsillectomy throat. I headed over to the bathroom and found that my urine was completely clear - a sign of excellent hydration. I mentally patted myself on the back and then headed downstairs for some pain relief. I thought about taking more medication, but I elected against it - after all, I hadn't yet waited the requisite four hours between doses and the pain hadn't yet reached a deafening crescendo. Instead, I quietly looted the freezer and took two orange popsicles up to my room as my prize. I wolfed them down and then went to sleep once more.

I woke back up at 8am, which in all honesty is not that bad. I can do with seven hours of sleep, especially when I feel like I have an angry dragon's throat without the necessary fire resistant tissue. Not gonna lie, it sucked. I struggled another 15mL of medication down my throat, and then waited for it to work its magic. Once it had hit me, I took my antibiotics, ate another popsicle or two, and then drank a bunch more ice water. Seeing as my writing skills are currently deteriorating due to the effects of the drug cocktail, I'll quickly try to describe the pain before signing off. After all, I assume that this is the information that most of you guys are after.

You see, physical pain largely comes in two types: acute and chronic. Acute pain is like the second after you stub your toe or burn your hand in a fire - it hurts a ton, forcing you to reflexively recoil. But while such pain might make you cry, it usually resolves itself fairly quickly. 

This stands in contrast to the sneaky pain that defines the post-tonsillectomy experience. You don't notice it at first - the combination of general anesthesia and shock prevent you from yet realizing the total extent of your idiocy. But slowly but surely it creeps up on you like an unavoidable tidal wave and then suddenly you find yourself trapped within. You probably still won't cry; you've already acclimatized to this new hellish state of being. But once seemingly simple motions like talking or swallowing will now provoke serious nociceptive protest. So you take your pain meds and slowly feel the once deafening roar of recovery recede to the outer edges of your consciousness. But it's still there, looming just beneath the outermost surface of your awareness. You are a tiny speck clinging to an opiate-induced raft in a sea of pain. Let's hope you can find solid ground. 

It's now 4:35pm. Today has been the worst day by far. It turns out that there are a few steps you can take in order to relieve yourself of the pain.

Firstly, and this is an obvious one, take your pain meds on time. I went into this ordeal thinking that I should just deal with the pain. Turns out that this strategy doesn't work out when the pain is so bad that you find yourself passing out. Instead, suck up your pride and use the medicine.

Secondly, vanilla ice cream milkshakes tend to do a pretty good job at covering the throat and thereby alleviate a bunch of the pain. Around twenty mins after you take your meds you ought to try to sip on one of these.

Thirdly, clear phlegm from your throat. It tends to block up your nasals and makes the entire perception of the experience much worse. Like most things, this is easiest to do twenty to thirty minutes after you take the painkiller.

Fourthly, don't be afraid to shower. I've found that the steam really helps to clear out my sinuses and is somewhat soothing.

Lastly, try to do some mild brushing of your front teeth. This seemed to really clean out a bunch of the gunk that I felt building up around me and made my breath not smell quite so bad. 

Friday, May 18 (Day 3)

Honestly, I've been pretty bad with keeping up with this journal so from here on out you are gonna get a much more general overview of what the process was like for me. While the pain was a bit better on Friday, I started to feel super sick on this day. My eyes became pretty photosensitive so I could no longer distract myself with television, and my sleeping habits became increasingly disjointed. I remember waking up repeatedly at like 3 or 4 am, unable to take more medicine. Additionally, I started to have a mild fever of roughly 100F to 101F. This fever persisted for roughly the next two days. 

Saturday, May 19 (Day 4) 

This was the day when the photosensitivity got the worst. I had to wear sunglasses to watch TV, and honestly even having one lamp was too much for me. When I called the ENT, he admitted that he had never seen such a symptom and recommended that I visit the ophthalmologist. I promptly visited the eye doctor, who said that while my eyes seemed to be a little dry they didn't seem to have any serious issues. Additionally, she informed me that I likely didn't have meningitis. I went to sleep for the rest of the day. Oh and also, the throat derived pain started to go down substantially around this time. I think that I ate a real meal for the first time this day - well mixed mashed potatoes and canned tuna. 

Sunday, May 20 (Day 5)

Pain continued to go down, I believe that I had stopped taken Hydrocodone by this time and had moved entirely to Tylenol. I finally had the genius idea to take Zyrtec, which completely solved my eye irritation and photosensitivity issues. 

Monday, May 21 (Day 6)

My fever broke on this day and my temperature then started to hover around 99F, eventually reaching 98F by the end of the day. I continued to take Zyrtec and ate a bunch of Annie's Pasta.

Tuesday, May 22 - Tuesday, May 29 (Days 7-14)

Basically the pain went from minor to almost not noticeable during this time. I still am hesitant to touch my toes as I can feel pressure building up in my throat, but other than that I'm pretty much totally functional. Even my voice has returned to normal for the most part. I had my post-op checkup today and the doctor said that while I probably shouldn't work out at full throttle, for the most part I should be back to normal. I've been eating whatever I want - even goldfish and salt and vinegar chips - without any issues. Overall, the surgery made me feel pretty crappy until Day 5 or so, but then after that my situation rapidly improved. Pain was probably worst around Day 2, and then after that the main gripe was photosensitive eyes (an unusual symptom) and my inability to talk. Just to give a more objective measure of pain, I ended up with about 2/3 of my opiates left so the pain isn't that bad - it's mostly just super uncomfortable. Good luck to anyone planning on going through with the surgery - you won't regret it!